Tools and Resources

Chapter 1: Making the Case for Population-based Cardiovascular Health Interventions

Glossary of Key Terms

Advertorial: An advertorial is a piece published in a newspaper or magazine and presented as an editorial but designed as a marketing piece to "advertise" a campaign, issue, product, or organization. An advertorial is sometimes printed as a supplemental section in a newspaper.

Advocacy: Advocacy is participation in the democratic process by taking action in support of a particular issue or cause. Advocacy efforts (e.g., education, awareness building, promotion, marketing, and/or social marketing) do not constitute lobbying as long as a policy maker is not urged to take a position or action on specific legislation.

Audience impressions: Audience impressions is an estimate of the number of individuals who saw or heard a particular news story, public service announcement, or other placement, based on average circulation, audience size, and rules of thumb. For print publications, multiply the circulation by 2.5. For radio and television stations, use the station's number of average daily listeners or viewers. For online media, numbers for average daily audience impressions can be obtained for individual Internet sites through companies such as Nielsen or NetRatings, which offer online subscription services.

Backgrounders: A backgrounder is a document containing detailed descriptions of an industry, organization, activity, or special issue that is provided to media, partners, policy makers, and other target audiences to provide them with a solid understanding of the topic.

Biographical summaries: Biographical summaries (bios) are a narrative form of a résumé that recount the most pertinent facts about an individual's background, expertise, and experience. Bios may be included in press kits.

Breaking news: Breaking news is news that has just been released to the public or has just occurred. Examples of breaking news include release of the results of a large study, a significant announcement made by a government official, or a major world event.

Cardiovascular disease (CVD): Cardiovascular disease includes diseases of the heart and blood vessels, coronary heart disease (coronary artery disease and ischemic heart disease), stroke (brain attack), high blood pressure (hypertension), rheumatic heart disease, congestive heart failure, and peripheral artery disease.

Cerebrovascular disease: Cerebrovascular disease affects the blood vessels supplying blood to the brain. Stroke occurs when a blood vessel bringing oxygen and nutrients to the brain bursts or is clogged by a blood clot. Because of this rupture or blockage, part of the brain does not receive the flow of blood it needs, and nerve cells in the affected area die. Small stroke-like events (e.g., transient ischemic attacks), which resolve in a day or less, are symptoms of cerebrovascular disease.

Coronary heart disease (CHD): Coronary heart disease is a condition in which the flow of blood to the heart muscle is reduced. Like any muscle, the heart needs a constant supply of oxygen and nutrients that are carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged, they cannot supply enough blood to the heart. If insufficient oxygen-carrying blood reaches the heart, the heart may respond with pain called angina. The pain usually is felt in the chest or sometimes in the left arm or shoulder. When the blood supply is cut off completely, the result is a heart attack. The part of the heart muscle that does not receive oxygen begins to die, and some of the heart muscle can be permanently damaged.

Daybook: The daybook is the daily listing of events for journalists, including press conferences, rallies, and other media events in a city. Reporters often check the daybook first thing in the morning to see what news is being announced that day. The Associated Press produces one of the most popular daybooks.

Drop-in article: A drop-in article is a completely prewritten news or feature story that can be published verbatim in a state health department publication, partner organizational newsletters, community magazines, shopping guides, and other local materials that regularly fall into the hands of key audiences.

Editorial board briefing: An editorial board briefing is a meeting with both the governing body of editorial writers and the editors who guide the editorial voice of a newspaper or magazine. Purposes may include challenging biased editorials or trying to persuade the publication to take an editorial position on an issue or to publish an Op-Ed. An editorial board briefing can be a highly effective avenue for pitching your opinion on a topic.

Embargo: An embargo is a prohibition on reporters that delays publication and airing of news until the slated date and time. Embargo is a strategy for getting information into the hands of key journalists before an event, so they have time to prepare thoughtful, well-researched coverage in advance of the "big announcement," perhaps at a press conference. "EMBARGOED UNTIL (date and time of release)" should be written across all documents given to reporters in advance. Most responsible reporters do not break embargoes.

Environmental interventions: Environmental interventions create changes to economic, social, or physical settings and enhance the ability of those settings to support healthy decisions. One example would be a statewide media campaign to inform the public that high blood pressure is a major modifiable risk factor for heart disease and stroke and that having blood pressure checked is an important first step in identifying and controlling high blood pressure and reducing the risk of heart disease and stroke.

Fact sheet: A fact sheet is a concise reference document containing the essential information of an industry, organization, event, outcome, or discovery. Typically one page, it lists pertinent information such as data, key numbers, and percentages. A fact sheet is useful for reporters who do not have time to read an entire press release or are looking for just one tidbit of information.

Feature story: A feature story is used to clarify news issues, take a human-interest angle, entertain and inform, profile an individual, or provide mood, atmosphere, and emotion to a publication.

Formative research: Formative research is conducted during the development of a program to help select and describe the target audience, understand the factors that influence its behavior, and determine the best ways to reach it. This research examines behaviors, attitudes, and practices of target groups; explores behavioral determinants; and uses primarily qualitative methods to collect and analyze data. Formative research may be used to complement existing epidemiologic and behavioral data to assist in program planning and design.

Frame: When a story is "framed," it is presented from a particular perspective both to attract journalists' interest in covering it and to ensure that the story is presented in a way that communicates a position effectively.

Health communication: Health communication is the art and technique of informing, influencing, and motivating individual, institutional, and public audiences about important health issues. The scope of health communication includes disease prevention, health promotion, health care policy, and the business of health care, as well as enhancement of the quality of life and health of individuals within the community.

Health promotion: Health promotion is any planned combination of educational, political, regulatory, and organizational support for actions and conditions of living that are conducive to the health of individuals, groups, or communities. Examples include educational campaigns to increase public awareness of the signs and symptoms of heart attack and stroke and policy changes to ensure universal 9-1-1 coverage.

Heart attack (acute myocardial infarction): A heart attack occurs when a coronary artery becomes completely blocked, usually by a blood clot (thrombus), resulting in lack of blood flow to the heart muscle and therefore loss of needed oxygen. As a result, part of the heart muscle dies (infarcts). The blood clot usually forms over the site of a cholesterol-rich narrowing (or plaque) that has burst (ruptured).

Heart disease: Heart disease is the leading cause of death and a common cause of illness and disability in the United States. Coronary heart disease and ischemic heart disease are specific names for the principal form of heart disease, which is the result of atherosclerosis—the buildup of cholesterol deposits in the coronary arteries that feed the heart.

Hook: A hook is a way of making a story interesting to a reporter. Examples of hooks include timeliness, anniversaries, controversy, localizing a national story, and dramatic human interest.

Individual behavior change intervention: An individual behavior change intervention is aimed at motivating changes in the behavior of individuals by increasing knowledge, influencing attitudes, challenging beliefs, or promoting the acquisition of new skills.

Key messages: Key messages are important points to be conveyed to the target audience in each communication with them. These messages might include succinct statements of (1) the problem, (2) the impact of the problem, and (3) the solution to the problem through policy and environmental change. For example, the problem could be, "Few people know what the numbers in their blood pressure reading mean."

Lead: The lead is the first line or paragraph of a news story, representing the initial and central point. News releases and media advisories should anticipate and provide the leads for reporters. If the lead of a news release doesn't grab a reporter's attention by the end of the first paragraph, he or she probably will not continue to read.

Letters to the editor: Every newspaper publishes a letters to the editor section on the editorial page. The purpose is to allow readers to express their point of view on a previous story or editorial. Letters can support or oppose the article or offer additional commentary.

Lobbying: Lobbying is an attempt to influence legislation through communication with legislators, staff persons, or another government official who participates in the formulation of legislation. The communication refers to a specific piece of legislation and reflects a view on that legislation.

Logic model: A logic model is a systematic and visual presentation of the perceived relationships among (1) the resources for operating a program, (2) the planned activities, and (3) the changes or results to be achieved.

Media advisory: A media advisory is a document sent to media outlets that provides basic information (who, what, when, where, and why) about an upcoming event, such as a press conference, that offers opportunities for interviews and/or photographs. Advisories are usually not more than one page long and contain information on how to contact the media liaison.

Media advocacy: Media advocacy is the strategic use of mass media to reframe issues, shape public discussion, or build support for a policy, point of view, or environmental change.

Media contact list: A media contact list is a list of the print, broadcast, and online reporters and other media outlets targeted for outreach. Lists typically include contact persons, titles, addresses, telephone numbers, fax numbers, and e-mail addresses.

Media lead sheet: A media lead sheet is designed to generate media interest in a selection of key issues, news angles, and/or feature ideas. This sheet usually includes three to five capsulated story suggestions.

Media liaison: The media liaison is the individual designated as the point of contact with the media. This person finds answers to questions posed by the media, provides information, contacts the media with news, identifies spokespeople, and helps to schedule spokesperson interviews.

Media partnership: A media partnership is a formal, established partnership with the promotion or advertising arm of a local media organization. In exchange for becoming associated with an important issue in the community, media partners may support local health education campaigns by publishing public service announcements or advertorial supplements, producing and airing television and radio public service announcements, and/or sponsoring special events.

Media pitch letter: A media pitch letter is a brief, targeted letter or e-mail message written to a journalist to convince him or her to cover a story. The letter should be written using the format of a standard, professional letter that outlines the information to be shared and why it is important.

Media relations: Media relations refers to establishing a positive working relationship between individuals in the organization and members of the news media to increase the likelihood that an issue will be covered favorably, thus helping to advance the program goals related to the issue. Media relations entails getting to know individual reporters, including the scope of their work and their interest areas; serving as a reliable, proactive provider of credible information about the issue; and being timely and responsive to media requests for interviews, additional contacts, and other resources.

News release (press release): News releases are the single most important method for communicating news to reporters. They summarize the news and provide print, broadcast, and online media with the relevant information about an upcoming activity or story idea. News releases are typically written like a news story. They contain quotes from a spokesperson(s) and background, and they use an inverted-pyramid style of writing, with the most important information in the first paragraph. If a reporter's attention is not piqued by the headline or by the end of the lead paragraph, he or she is not likely to read any further.

Op-Ed (opinion-editorial): An Op-Ed is typically written in the form of a letter, statement, article, or short essay that is submitted to a newspaper editor by a reader or a representative of an organization. The Op-Ed usually expresses a strong opinion or point of view about an issue and is backed by well-researched and documented facts. Op-Eds appear on the page opposite the editorial page or during the "point/counterpoint" portion of radio and television shows. An Op-Ed is useful to communicate about an issue in a person's own words, but it should also clearly state the key messages.

Outcome evaluation: Outcome evaluation is the systematic collection of information to assess the impact of a program and to measure the extent to which it has accomplished its stated goals and objectives. This information can be used to form conclusions about the merit or worth of a program and to make recommendations about future direction or improvement of the program.

Photo op (photo opportunity): A photo op is a staged, high-impact image that communicates a message. It is useful because a photograph or a strong television picture can move an audience much more directly than words.

Pitch: To pitch is to provide an idea for a news story to reporters, producers, or editors and get them excited about covering it.

Policy intervention: A policy intervention influences the development of formal and informal policies (laws, regulations, and rules) that affect health. An example is an intervention to persuade health care centers to enact and enforce a policy that requires physicians to attend an annual training session on guidelines for prescribing statin drugs for treatment of high blood cholesterol levels.

Policy maker: A policy maker is a person who has the authority and position to influence the development of formal and informal laws, regulations, and rules. Policy makers include legislators, hospital administration staff, health maintenance organizations, the heads of governmental agencies that set regulatory policy, and the presidents and chief executive officers of work sites.

Population-based strategy: A population-based strategy is an intervention that focuses on an identified population (e.g., women ages 35-65 years), community (e.g., residents of Madison County), or system (e.g., statewide public school systems, major funders of employee health benefit packages, as opposed to individual behavior change. Strategies should include communication to raise awareness and generate support for policy and environmental changes that help to prevent heart disease and stroke.

Press kit (media kit, press packet, or information kit): A press kit is generally handed out in a folder that opens to reveal two pockets and contains such items as a news release, fact sheets, biographies, copies of statements delivered at a press event if the kit is being distributed at a press event, and possibly a copy of a report that is being released. A press kit developed for a specific issue can be handed out at an event or mailed to reporters who cannot attend. A generic press kit, which is not specific to an issue, can also be helpful. This kit typically contains information about the organization and can be handed out to reporters at any time to provide background information.

Press release: See news release.

Primary audience (target audience): The primary audience is the main object of a campaign. For example, if the workgroup seeks to educate legislatures about the pros and cons of incentives for hospitals to provide specialized stroke centers, the primary audience would likely be policy makers.

Primary prevention: Primary prevention targets populations that are at increased risk for a first event resulting from cardiovascular disease (e.g., heart attack, heart failure, or stroke), because they have one or more risk factors for CVD. Guidelines from the American Heart Association and other national organizations advocate for primary prevention of CVD by addressing the risk factors of high blood pressure, high cholesterol, tobacco use, poor nutrition, physical inactivity, overweight and obesity, and diabetes.

Priority populations: Priority populations are population groups that have higher documented rates of cardiovascular diseases and related risk factors; lack access to services; or represent greater socioeconomic disparities than those in the general population.

Process evaluation: Process evaluation is the systematic collection of information to document and assess how well a program is being implemented. Process evaluation includes assessments, such as whether materials are being distributed to the appropriate people and in sufficient quantities; whether and to what extent program activities are occurring; whether and how frequently the target audience is being exposed to relevant advertisements; and other measures of how well the program is being implemented. This information can help to determine whether the original program is being implemented as designed, and it can be used to improve the program's delivery and efficiency.

Public health communication: As a form of health communication, public health communication involves a translation process that begins with the basic science of what is known about a health topic. From the science, public health professionals derive messages about attitudes and behaviors that the public should adopt and policies that organizations and government should enact to support population health.

Public service announcement (PSA): A public service announcement is a form of advertising that is delivered free of charge via a media outlet (e.g., magazine, newspaper, radio station, television station, Web site, outdoor venue).

Risk factor: A risk factor increases a person's chance of developing a disease. Risk factors for heart disease and stroke include high blood pressure, high cholesterol, tobacco use, physical inactivity, and poor nutrition.

Secondary (gateway) audience: A secondary audience is a group that influences the primary audience or has a strong interest in promoting an intervention in the primary audience. For example, if the workgroup seeks to educate legislatures about the pros and cons of incentives for hospitals to provide specialized stroke centers, the primary audience likely would be policy makers whose actions may be influenced. The secondary audience would be groups of individuals who influence policy makers, including constituent groups, hospital administrators, health providers, and consumer advocacy organizations.

Secondary prevention: Secondary prevention targets populations with established CVD to prevent recurrent events (e.g., heart attack, heart failure, or stroke). Strategies include ensuring compliance with guidelines on use of aspirin, beta-blockers, ACE (Angiotensin Converting Enzyme) inhibitors, anticoagulants, and other antiplatelet agents. In addition, reducing risk factors through lifestyle changes, such as losing weight, and policy or environmental changes, such as declaring work sites and schools tobacco free, are important strategies for secondary prevention as well as primary prevention.

Settings (health care sites, work sites, schools, and the community): Settings are major social structures that provide channels and mechanisms of influence for reaching defined populations and for intervening at the policy level to facilitate healthful choices and address quality-of-life issues. Health promotion and primary and secondary prevention may occur within these individual settings or across all of them.

Spokesperson: A spokesperson is the messenger of your issue or organization. He or she embodies the professionalism of an organization and communicates the urgency of an issue. It is important to identify key spokespeople and make them available to reporters for quotes and interviews. The spokesperson can be an organizational leader or community member. The best spokespeople command media attention; present a poised, confident, and persuasive image; and stay on message.

Stakeholder: A stakeholder is an individual or group with an interest in the success of an organization in delivering intended results and maintaining the viability of the organization's products and services. Stakeholders influence programs, products, and services.

State Heart Disease and Stroke Prevention Program, Basic Implementation: Basic implementation is a funding level for the CDC's State Heart Disease and Stroke Prevention Program. A basic implementation program is expected to (1) implement, disseminate, and evaluate intervention activities throughout and within the state, state-level organizations, and settings; (2) monitor secondary prevention strategies; (3) complement professional education activities; and (4) extend resources to local health agencies, communities, and organizations.

State Heart Disease and Stroke Prevention Program, Capacity Building: Capacity building is a funding level for the CDC's State Heart Disease and Stroke Prevention Program that provides for increased capacity and planning activities that support promotion of cardiovascular health and functions of disease prevention and disease control. Program components include the following: (1) partnerships and program coordination related to primary and secondary prevention, (2) scientific capacity to define the CVD burden, (3) inventory of policy and environmental strategies, (4) a state plan for CVH promotion, (5) training and technical assistance, (6) population–based intervention strategies, and (7) culturally competent strategies for addressing priority populations.

Strategic communication: Strategic communication is the process by which information is formulated, produced, and conveyed to achieve specific objectives vital to an organization's mission.

Strategic frame analysis: Strategic frame analysis is an approach to communication research and practice that is used to help people deal with public issues. "Framing" refers to the construct of a communication—its language, visuals, and messengers—and the way it signals to the listener or observer how to interpret and classify new information. "Strategic" refers to an approach that deconstructs the dominant frames of reference that drive reasoning on public issues; it identifies the alternative frames most likely to stimulate reconsideration of an issue on the public agenda.

Stroke: A stroke is a form of cerebrovascular disease that affects the arteries of the central nervous system. It occurs when blood vessels bringing oxygen and nutrients to the brain burst or become clogged by a blood clot or some other particle, which blocks the flow of blood to part of the brain. Deprived of oxygen, nerve cells in the affected area cannot function and die within minutes. When nerve cells cannot function, the part of the body controlled by these cells cannot function either.

Wire service: A wire service is a news source that files stories to newspapers and radio and television stations across the country. Media outlets then "pull" the stories off the wire to print or air them locally. Local stories posted through a wire service can be picked up by newspapers nationwide. Examples of mainstream wire services include: Associated Press, Reuters, Copley, Dow Jones, Gannett, Knight-Ridder, New York Times News Service, Scripps-Howard, States, and United Press International. PR Newswire and Business Wire are two large public relations wire services that transmit news releases and story ideas directly into newsrooms for a fee.

Workgroup: A workgroup is a coalition of people and organizations working specifically on communication interventions related to cardiovascular health. Workgroups can enhance existing state coalitions, facilitating overall program development and implementation.

Sources:

CDC CVH Branch Strategic Plan, August 2001, Healthy People 2010, and Promising Practices in Chronic Disease Prevention and Control, 2003.

CDC Office on Smoking and Health (OSH) Glossary.

Institute of Medicine, Who Will Keep the Public Healthy? Educating Public Health Professionals for the 21st Century, November 2002.

Karel, F. Getting the Word Out. To Improve Health and Health Care 2001: The Robert Wood Johnson Foundation Anthology. San Francisco, CA: Jossey-Bass, 2001.

NCI/NIH, Making Health Communication Programs Work, 2003.

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CDCynergy 2001: Cardiovascular Health Edition

CDCynergy 2001 Basic is an interactive Web–linked/CD–ROM tool that can be used to plan communication interventions for policy and environmental change. The tool was originally created in 1998 by the CDC Office of Communication for use by CDC staff and then updated in 2001 for internal and external use by public health professionals and their partners at national, state, and local levels. Key features are an online notebook, case examples, a glossary of health communication terminology, a media library, and resources for health communication planning and evaluation.

CDCynergy 2001 Basic has been tailored for multiple public health topics, including cardiovascular health (CVH). The CDCynergy 2001—Cardiovascular Health Edition was developed by the CDC CVH Branch with input from other CDC chronic disease programs, State Heart Disease and Stroke Prevention Programs, partners, and organizations concerned with heart health. These organizations included the American Heart Association; the National Heart, Lung, and Blood Institute; and the CDC chronic disease programs for tobacco, diabetes, nutrition, and physical activity.

The CDCynergy 2001—Cardiovascular Health Edition has the same features as CDCynergy 2001 Basic, but its case examples and many of its resources are specific to heart disease and stroke and the risk factors for these conditions. The case examples focus on a social marketing campaign on signs of heart attack, a school physical activity intervention, and a faith–based nutrition intervention. The resources include Web site links, online journals, and planning guides related to prevention of heart disease and stroke.

The primary intended users for the CDCynergy 2001—Cardiovascular Health Edition are State Heart Disease and Stroke Prevention Programs and their partners who wish to systematically develop health communication plans and strategies that support their overall program goals. The tool can guide State Heart Disease and Stroke Prevention Programs and their partners through a process to:

• Acquire a thorough understanding of a heart disease or stroke problem and whom it affects within their state.
• Explore a wide range of population–based strategies for the primary and secondary prevention of heart disease and stroke within their state.
• Select the most promising population–based strategies for influencing a heart disease or stroke problem within their state.
• Understand the role of communication in planning, implementing, and evaluating the selected population–based strategies.
• Develop a comprehensive communication plan that includes audience research, pretesting, production, implementation, and evaluation.

CDCynergy 2001—Cardiovascular Health Edition does not assume that communication is the solution to a public health problem but instead guides users through a six–phase process to help them identify how communication can best support their program goals and objectives. The six logical CDCynergy 2001 planning phases are (1) problem definition and description, (2) problem analysis, (3) audience identification and profiling, (4) development of communication strategy and tactics, (5) development of an evaluation, and (6) launch and feedback. The CDC Office of Communication describes these phases in greater detail at http://www.cdc.gov/communication.

Copies of the CD–ROM for the CDCynergy 2001—Cardiovascular Health Edition and training materials are available at no cost from the CDC CVH Branch. The current version of the CDCynergy 2001—Cardiovascular Health Edition will be updated and modified in the future for the Web. Information about its online availability will be placed on the CDC Heart Disease and Stroke Prevention Web site, http://www.cdc.gov/dhdsp/, when the conversion project is completed.
 

Date last reviewed: 05/12/2006
Content source: Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion